Researchers from University of South Florida College of Medicine found a combination of antibiotics to be an effective treatment for Chlamydia-induced reactive arthritis, a major step forward in the management, and possibly cure, of this disease. Results of this study are published in the May issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology.
Reactive arthritis (ReA), also known as Reiter's syndrome, occurs in response to an infection. According to National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the bacterium most often associated with ReA is Chlamydia trachomatis. Respiratory infections with Chlamydia pneumoniae can also trigger ReA, while associated infections in the digestive tract include Salmonella, Shigella, Yersinia, and Campylobacter. ReA symptoms usually last 3 to 12 months, although symptoms can return or develop into a long-term disease. In the past it was thought that only a small percentage of people would experience chronic symptoms of ReA. However, more recent data suggests that as many as 30%-50% of patients could develop a chronic form of the disease. In chronic ReA, symptoms can be severe and difficult to control with treatment, which could lead to joint damage.
The use of long-term antibiotic treatment for patients with ReA is controversial. Several reported studies have indicated that prolonged antimicrobial monotherapy is not efficacious, while other studies suggest there might be a benefit, specifically with early-stage Chlamydia-induced ReA.
The study led by J.D. Carter, M.D., focused on combinations including 2 antibiotics found to have specific effects on the Chlamydia bacteria. The first, rifampin, has excellent tissue penetration, an important weapon against intracellular pathogens such as Chlamydia. Rifampin also has been shown to interfere with chlamydial gene transcription, including the heat-shock proteins (HSPs), which can ultimately lead to the demise of the infected cell. Dr. Carter explains why this is important. "Combining this effect with antibiotics that block chlamydial protein synthesis (e.g., doxycycline or azithromycin) may allow for successful eradication of the cell harboring persistently infecting intracellular organisms. A recent pilot study conducted by our group suggested that prolonged treatment with a combination of doxycycline and rifampin significantly improves symptoms of chronic undifferentiated spondylarthritis (SpA) (with a special focus on Chlamydia) compared with doxycycline alone. The goal of the present study was to further investigate whether a 6-month course of combination antibiotics, one of which is rifampin, is effective in the treatment of patients with chronic Chlamydia-induced ReA."
The 9-month, prospective, double-blind, triple-placebo trial screened a total of 80 subjects, and 42 were enrolled and randomized to treatment. Twelve subjects were randomized to doxycycline and rifampin, 15 were randomized to azithromycin and rifampin, and 15 were randomized to matching oral placebos. The primary end point—an improvement of 20% or more—was achieved in 17 of 27 patients (63%) receiving combination antibiotics and in 3 of 15 patients (20%) receiving placebo. Secondary efficacy end points showed similar results, demonstrating that compared with placebo, a 6-month course of combination antibiotics resulted in a significantly higher response rate in patients with chronic Chlamydia-induced ReA, although which combination of antibiotics was most effective remained undetermined as the trial wasn't powered to compare the 2 regimens.
Dr. Carter concludes, "The results of this study are encouraging for the management of chronic post-Chlamydia ReA. These data suggest that there is potential for eradication of this persistent infection and that improvement in the clinical sequelae that are the result of these infections can be achieved in a substantial number of patients."
In an Editorial published in this month's issue, Dr. Henning Zeidler agrees. "The study by Carter et al shows impressive effects and, with them, the potential for the eradication of Chlamydia, which would cure Chlamydia-induced ReA."
Article: "Combination Antibiotics as a Treatment for Chronic Chlamydia-Induced Reactive Arthritis." J. D. Carter, L. R. Espinoza, R. D. Inman, K. B. Sneed, L. R. Ricca, F. B. Vasey, J. Valeriano, J. A. Stanich, C. Oszust, H. C. Gerard, and A. P. Hudson. Arthritis & Rheumatism; Published Online: April 29, 2010 (DOI: 10.1002/art.27394); Print Issue Date: May 2010.
Editorial: "Combination Antibiotics for Chlamydia-Induced Arthritis: Breakthrough to a Cure?" Markus Rihl, Jens G. Kuipers, Lars Kohler, Henning Zeidler. Arthritis & Rheumatism; Published Online: April 29, 2010 (DOI: 10.1002/art.27401); Print Issue Date: May 2010.
These studies are published in Arthritis & Rheumatism. Media wishing to receive a PDF of these articles may contact email@example.com
Arthritis & Rheumatism is an official journal of the American College of Rheumatology and covers all aspects of inflammatory disease. The American College of Rheumatology (www.rheumatology.org) is the professional organization who share a dedication to healing, preventing disability, and curing the more than 100 types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members include practicing physicians, research scientists, nurses, physical and occupational therapists, psychologists, and social workers. For details please visit, http://www3.interscience.wiley.com/journal/76509746/home
Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or www.interscience.wiley.com.
Dawn Peters | EurekAlert!
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
08.12.2016 | Life Sciences
08.12.2016 | Physics and Astronomy
08.12.2016 | Materials Sciences